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Wednesday, October 31, 2007

An acute shortage of trained doctors is sabotaging Liberia's efforts to deliver health care to its people.

Health Minister Walter Gwenigale says Liberia needs at least 1,200 doctors to grapple with its post-war situation but currently it has only 120.

And 70 of those are foreign doctors serving with international non-governmental organisations and the United Nations.

"We have a serious shortage of health manpower, not just doctors; we need doctors but we also need more nurses, more midwives and more laboratory technicians," Mr Gwenigale said.

"If we have enough doctors we will be able to properly cover (Liberia's) 15 counties," he said.

"Right now a county is lucky if it even has one."

Like other civil servants, Liberian doctors are underpaid, leading many to change profession or travel abroad for employment opportunities.

In addition, nearly all the available doctors prefer to take up assignments in Monrovia and the other coastal towns, leaving the rural sector inland to quacks or ill-prepared health workers.

Mr Gwenigale said that to encourage doctors to take assignments up-country, their pay would be increased to about $1,000 - that's five times the current average salary.

"To be able to really deliver health care to our people you have to go beyond hospitals, but the shortage of trained manpower is greatly hampering us."

The next generation

Liberia has only one medical college which turns out between six and 12 graduates each year.

Medical students complain of no light to study by

But there is no guarantee that even these graduates will take up assignments at home.

And medical students at the college, which is a part of the University of Liberia, complain about the conditions in which they are expected to live and train, with a lack of electricity and running water in their dormitories.

"The dormitory is not even conducive for people to live; medical students need to study for up to six hours a day but here we study on candles," said student spokesman Robert Mulbah.

In addition to the lack of light and water "we don't even have food", he said.

The dean of the college, Dr Tarbeh Freeman, admitted there were problems but said engineers were working on the electricity supply and the government was taking steps to provide the students with what they need.

President Johnson-Sirleaf has promised more assistance

He was referring to assurances made by President Ellen Johnson-Sirleaf during a recent visit to the medical school, when she promised government assistance.

In the meantime, private nursing schools are mushrooming across Monrovia - but the Ministry of Health warns that some of them are failing to meet the minimum standards.

All hands on deck

The acute shortage has caused former officials with medical backgrounds to return to active duty.

Only a few private clinics have suitable training facilities

Former Health Minister Dr Peter Coleman is one of them and he was blunt in explaining the challenge faced by doctors in Liberia.

"We are all overworked. We are talking about a doctor to patient ratio of one to 50,000. That puts a lot of stress on the professionals."

"There will be a lot of people left out because doctors need time to interact with patients," Dr Coleman said as he prepared for a surgical operation at Liberia's John F. Kennedy Hospital - the country's biggest.

To pay a doctor or consultant a $200 monthly salary "is not encouraging at all," says Dr Coleman.

"This is why we see an exodus of trained doctors from Sub-Saharan Africa going to seek greener pastures abroad."